• Maryland does have a certified doula pathway for Medicaid (currently for childbirth doulas) with rules about certification, enrollment, and documentation. However, it does not regulate elder care or end-of-life doulas specifically under a Medicaid program at this time. 

• Those rules apply to birthing doulas (perinatal support) and focus on certification and Medicaid billing criteria. 

• As an RN you are regulated under the Maryland Nurse Practice Act, which defines what clinical tasks you can perform. Medical tasks (assessments, delegations, care planning, delegating tasks to aides, documentation) must follow the Board’s scope. 

• Elder care doula services are non-clinical even when delivered by an RN — meaning the RN contributes support and advocacy, but does not provide medical treatment as part of doula scope. Clinical nursing actions remain separate from doula services.

Services provided are educational and supportive in nature and may include:

• Health education and skill reinforcement

• Caregiver and family support

• Health system navigation and resource coordination

• Goal setting and wellness support

Services do NOT include medical diagnosis, treatment, prescribing, or replacement of care from a licensed provider.

The RN Elder Care Consultant does not provide direct medical interventions (e.g., prescribing medications) unless licensed in an advanced practice role (e.g., NP). The focus is on assessment, education, advocacy, and care coordination.